My advice to students: never work for a hospital system

Whenever I talk to medical students, as any medical student who is a member of the Benjamin Rush Institute will tell you, I leave them with one piece of advice: never go to work for a hospital. Never go to work for a hospital system. Why do I tell them this? I believe that it’s just a matter of time, if a physician is an employee of a hospital, before the interest of their patient collides with the interest of of their employer. This is no situation a physician should ever find themselves in. The only way to avoid this situation is to never go to work for a hospital.

Primary care physicians, for instance, are graded and shown reports on the extent that they have ordered tests inside of the system or the extent to which that they have made specialty referrals inside of the system. A patient could never know that they were referred to a surgeon, for instance, because he was the right surgeon for the job, or he just happened to be a surgeon who worked for that hospital system.

A very brave and courageous number of physicians who are hospital employees continue to refer outside of the system and do the right thing and get the patients to where they need to go. An even braver and more courageous group is leaving hospital employment and setting up private practice so they can work work for their patients in a completely uncompromised way.

The free market movement in the United States is peeling away the grip that his big hospital cartel has on healthcare in the United States. As this happens, hospitals do not have the revenue to so aggressively purchase physician practices and buy medical students who are heavily in debt and coming out of training.

This is very exciting development because the quality of healthcare, I would argue, is going to improve as the hospital are increasingly unable to buy medical students or buy physician practices.

I know that this is radical and very upsetting to many of you watching this, but I believe very strongly in this and that is why when I talk to medical students the first and the last thing I tell them is to never go to work for a hospital system because at that point, they cannot, in an uncompromising way, be working for their patient.